• 医学文献
  • 知识库
  • 评价分析
  • 全部
  • 中外期刊
  • 学位
  • 会议
  • 专利
  • 成果
  • 标准
  • 法规
  • 临床诊疗知识库
  • 中医药知识库
  • 机构
  • 作者
热搜词:
换一批
论文 期刊
取消
高级检索

检索历史 清除

医学文献 >>
  • 全部
  • 中外期刊
  • 学位
  • 会议
  • 专利
  • 成果
  • 标准
  • 法规
知识库 >>
  • 临床诊疗知识库
  • 中医药知识库
评价分析 >>
  • 机构
  • 作者
热搜词:
换一批

针刺治疗难治性胃食管反流病食管动力疗效评价

Effects of acupuncture on esophageal motility of patients with refractory gastroesophageal reflux disease

摘要:

目的:研究针刺治疗后难治性 GERD 患者食管动力障碍的改善情况。方法选取2012年9月至2014年3月难治性 GERD 患者40例,均分为试验组和对照组,进行高分辨率食管测压阻抗检测。首次检测结束后,对照组平卧30 min,试验组则接受针刺治疗,所选穴位为内关、公孙、足三里,治疗时间为30 min。之后再次进行高分辨率食管测压阻抗检测。使用 ManoView ESO 3.0测压分析软件进行结果分析,参数包括单口吞咽蠕动缺损情况、下食管括约肌(LES)静息压、LES 残余压、LES 长度、上食管括约肌(UES)静息压、远端波波幅、蠕动持续时间、蠕动波起始速度、收缩前沿速度、远段收缩积分,并行卡方检验和 t 检验。结果试验组治疗前后正常吞咽所占比例分别为56.0%(112/200)和74.0%(148/200),食管内液体排空障碍比例分别为31.5%(63/200)和11.5%(23/200),差异均有统计学意义(χ2=14.242、23.700,P 均<0.01),而对照组平卧前后差异均无统计学意义(P 均>0.05)。试验组治疗前后 LES 静息压分别为(20.2±8.8)和(26.3±10.1)mmHg(1 mmHg=0.133 kPa),LES 长度分别为(2.2±0.6)和(3.3±0.8)cm,UES 静息压分别为(60.2±21.9)和(41.1±16.8)mmHg,差异均有统计学意义(t=5.519、6.580、6.881,P 均<0.01),LES 残余压治疗前后差异无统计学意义(P >0.05)。对照组平卧前后 LES 静息压和 LES 残余压均差异无统计学意义(P 均>0.05),但平卧前后 LES 长度[分别为(2.3±0.6)和(2.5±0.6)cm]和 UES 静息压[分别为(67.4±21.2)和(53.5±18.1)mmHg]差异均有统计学意义(t=2.530、6.652,P 均<0.05)。试验组治疗前后远端波波幅分别为(73.7±28.3)和(88.5±29.1)mmHg,蠕动持续时间分别为(2.9±0.4)和(3.2±0.4)s,远端收缩积分分别为(977.7±733.2)和(1225.9±945.1)mmHg ·cm·s,差异均有统计学意义(t =7.907、3.404、3.325,P 均<0.01),但蠕动波起始速度、前沿收缩速度差异均无统计学意义(P 均>0.05)。对照组平卧前后远端波波幅、蠕动持续时间、蠕动波起始速度、前沿收缩速度、远端收缩积分差异均无统计学意义(P 均>0.05)。结论针刺治疗能提高难治性 GERD 患者 LES 静息压,增加 LES 长度,提高食管体部整体蠕动压力及完整性,提高正常吞咽所占比例。

更多
abstracts:

Objective To investigate the effects of acupuncture on the improvement of esophageal motility disorder in patients with refractory gastroesophageal reflux disease (GERD).Methods From September 2012 to March 2014,40 patients with refractory GERD were enrolled and evenly divided into the treatment group and the control group. High resolution esophageal impedance manometry was conducted in patients.After the first examination,patients of the control group lay down for 30 minutes, and patients of the treatment group received acupuncture treatment at Neiguan,Gongsun and Zusanli points for 30 minutes.Then all the patients underwent high resolution esophageal impedance manometry again.ManoView ESO 3.0 software was used for analysis.The parameters included swallowing peristalsis defect,lower esophageal sphincter (LES)pressure,LES residual pressure,LES length,upper esophageal&nbsp;sphincter (UES)pressure,distal wave amplitude,peristalsis duration time,starting speed of peristalsis wave,speed of edge contraction and integration of the peristaltic waves.Chi-square test or t test was performed for data analysis.Results The percentage of normal swallows of the treatment group before and after treatment was 56.0% (112/200)and 74.0% (148/200),the percentage of delayed esophageal emptying was 31 .5 % (63/200 )and 11 .5 % (23/200 ),and the differences were statistically significant (χ2 =14.242 and 23.700,both P <0.01 ).However there was no significant difference in those of the control group (both P > 0.05 ).The LES resting pressure of the treatment group before and after treatment was (20.2 ±18.8)mmHg (1 mmHg=0.133 kPa)and (26.3±10.1)mmHg,the length of LES was (2.2 ±0.6 )cm and (3.3 ±0.8)cm,the distal esophageal peristaltic amplitude was (60.2 ± 21 .9)mmHg and (41 .1 ± 16.8 )mmHg,and the differences were statistically significant (t = 5 .519, 6.580 and 6.881 ,all P <0.01 ).There was no significant difference in LES residual pressure before and after treatment (P >0.05 ).There as no significant difference in LES resting pressure and LES residual pressure of the control group before and after lying down (both P >0.05 ).However,before and after lying down,there were significant differences in the length of LES ((2.3 ±0.6)cm vs (2.5 ±0.6)cm) and UES resting pressure ((67.4 ±21 .2 )mmHg vs (53.5 ±18.1 )mmHg)in the control group (t =2.530 and 6.652,both P <0.05 ).The distal wave amplitude of the treatment group before and after treatment was (73.7 ±28.3)mmHg and (88.5 ±29.1 )mmHg,the duration of peristalsis was (2.9 ± 0.4)s and (3.2 ± 0.4 )s,the distal contraction integral was (977.7 ± 733.2 )mmHg · cm · s and (1 225 .9±945 .1)mmHg·cm·s.All the differences were statistically significant (t=7.907,3.404 and 3.325 ,all P <0.01).There were no statistically significant difference in the beginning speed of peristaltic wave and the contractile front velocity (CFV)(all P >0.05).Before and after lying down,there was no significant difference in distal wave amplitude,duration of peristalsis,the beginning speed of the peristaltic wave and CFV of the control group (all P >0.05 ).Conclusion Acupuncture can help increase the LES resting pressure,extend the length of LES,improve the overall peristaltic pressure and completeness of esophageal somatic part,meanwhile,it increases the percentage of normal swallows of patients with refractory GERD.

More
  • 浏览:354
  • 下载:204

加载中!

相似文献

  • 中文期刊
  • 外文期刊
  • 学位论文
  • 会议论文

加载中!

加载中!

加载中!

加载中!

扩展文献

特别提示:本网站仅提供医学学术资源服务,不销售任何药品和器械,有关药品和器械的销售信息,请查阅其他网站。

  • 客服热线:4000-115-888 转3 (周一至周五:8:00至17:00)

  • |
  • 客服邮箱:yiyao@wanfangdata.com.cn

  • 违法和不良信息举报电话:4000-115-888,举报邮箱:problem@wanfangdata.com.cn,举报专区

官方微信
万方医学小程序
new翻译 充值 订阅 收藏 移动端

官方微信

万方医学小程序

使用
帮助
Alternate Text
调查问卷